Objective To explore the feasibility,necessity and the skill of total mesoesophageal excision (TME ) during thoracoscopy combined with laparoscopy in radical resection of esophageal carcinoma.Methods 69 patients with esophageal carcinoma were divided into the TME group(40 cases)and the thoracotomy with triple incisions group(29 cases)according to the admission sequence.The operation time,intraoperative blood loss,total lymph nodes removed,postoperative complication rate and disease -free survival were compared between the two groups.Results The operation time of TME group was (182.85 ±26.73)min,which was significantly shorter than (295.71 ±19.50)min of the thoracotomy group (t=-19.301,P<0.001).The intraoperative blood loss in TME group was (86.43 ±59.34)mL,which was significantly less than (163.47 ±58.82)mL in the thoracotomy group (t=-5.342,P<0.001 ).No significant differences were detected between the two groups in total lymph nodes removed and incidence rate of postoperative complication (all P>0.05 ).The disease-free survival period in TME group was (14.78 ±2.14)months,which in the thoracotomy group was (13.10 ±4.09)months,the difference was significant (t=2.200,P<0.05).Conclusion TME is safe and feasible during thoracoscopy combined with laparos-copy in radical resection of esophageal carcinoma.TME is better in improving the regional control in esophageal carci-noma.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

Emerging evidence has indicated that circular RNAs (circRNAs) play pivotal roles in the regulation of cellular processes and are found to be aberrantly expressed in a variety of tumors.However,the clinical role of circRNAs in bladder cancer (BC) and the molecular mechanisms have yet to be fully understood.In this study,the clinical specimens were obtained and the expression level of a circRNA BCRC4 was detected by real-time PCR in both BC tissues and cell line.The circular RNA over-expression plasmid was constructed and transfected into BC cells and related cell line.The cell cycles and apoptosis were observed using inverted microscope and flow cytometry.Western blotting was used to compare the relative protein expression of groups with different treatments.It was found that circRNA BCRC4 expression was lower in BC tissues than in adjacent normal tissues.Furthermore,consequences of fomed-expression of BCRC4 promoted apoptosis and inhibited viability of T24T and UMUC3 cells,and up-regulated BCRC4-inereased miR-101 level,which suppressed EZH2 expression in both RNA and protein levels.In addition,gambogic acid (GA) is a promising natural anticancer compound for BC therapy,and GA treatment increased the BCRC4 expression in T24T and UMUC3 cells in a dose-dependent manner.Altogether,our findings suggest that BCRC4 functions as a tumor suppressor in BC,and mediates anticancer function,at least in part,by up-regulating the expression of miR-101.Targeting this newly identified circRNA may help us develop a novel strategy for treating human BC.

There are 250 species of Zanthoxylum (Rutaceae) in the world. This genus distributed in tropical and subtropical regions. Alkaloids are the major and representative ingredients in these plants including quinolines, isoquinolines, and amide alkaloids, with such biological activities as anti-tumor, anti-inflammatory, analgesic, anti-virus, anti-platelet aggregation, anti-bacteria and anti- oxidant. These species have been used for a long time to treat toothache, urinary and venereal diseases, lumbago and rheumatism. This review summarizes the chemical constituents and pharmacological activities from the Z. sppplants, in an effort to the systematic research and application of the alkaloids of this genus.
Alkaloids ; chemistry ; pharmacology ; Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Structure ; Zanthoxylum ; chemistry

Objective To explore the cosmetic effect of oncoplastic volume displacement in breastconserving surgery.Methods 43 cases of breast cancer in stages I and Ⅱ with pathological diagnosis by core needle biopsy were operated by extended resection of tumor combined with axillary lymph nodes dissection.Among the patients,wound cavity was repaired by direct skin suture without suture of mammary gland deletion in 22 cases,and another 21 cases were repaired by oncoplastic volume displacement technique in which skin suture followed by freeing remaining breast tissue flap and translocation to repair the mammary defect.All of them were treated with three-dimension conformal radiotherapy,standard chemotherapy and endocrine therapy after operation.3 years after partial removal of breast,a retrospective historical control study had been fulfilled to analyze breast cosmetic results between two groups.Results In direct suture group,the cosmetology score was 4.3 points and fine rate was 40.9% (9/22).In breast reconstruction group.the score was 4.8 points and fine rate was 71.4% (15/21).The breast cosmetic effect in breast reconstruction group was significantly better than that in direct suture group (P<0.01).Conclusion It will get better breast cosmetic results after operation to utilize oncoplastic volume displacement suture technique in breast-conserving surgery.

Objective To explore the therapeutic effect of Jinkoubao on oral ulcer in rabbits and its action mechanism.Methods Among 60 SPF NewZealand rabbits,6 cases were randomly selected for the ulcer model identification,and the rest was randomly and equally divided into 3 groups:the control group (NC group),normal saline drug film group (NS group) and Jinkoubao film group (JK group).The rabbit model of oral ulcer was constructed by applying 40 ％ glacial acetic acid to burn rabbit oral mucosa for duplicating the oral ulcer model.of the change situation of oral ulcer was observed on the same day for constructing model,on 3,5,7 d after medication.The EGF level in oral mucosal tissue was detected by using RT-PCR and the local histopatho1ogical changes in oral ulcer was observed by using HE staining method.Results Compared with the NS group,the ulcer area on 3,5,7 d after medication in the JK group was significantly deceased (P＜0.01).Compared with the NS group,the EGF level in oral buccal mucosal tissue in the NS group and JK group was markedly increased (P＜0.01).But the EGF level increase in the JK group was faster than that in the NS group,the difference was statistically significant(P＜0.01).The HE staining section of rabbit oral ulcer on 3,5,7 d after medication showed that the inflammatory cells decrease in the JK group was more obvious than that in the NS group,fibroblasts proliferation was obvious and epithelial hyperplasia was good.Conclusion Jinkoubao could greatly improve the symptoms of oral ulcer in rabbits and promotes its healing,which is possible to strengthen the repair capacity of oral ulcer by regulating the EGF level.

Objective To analyze the clinical features of patients with prostate adenocarcinoma under 50 years.Methods Between January 2008 and April 2014,we reviewed 21 cases with prostate cancer under 50 years old.The mean age in those patients was 48 years old (ranged 42-49 years old).Their tPSA level was elevated,including＞10 μg/L in 17 cases,4-10 μg/L in 4 cases.21 cases were all confirmed by pathology.The results Gleason score showed 6 scores in 3 cases,7 scores in 6 cases (3+4 scores in 5 cases and 4+3 scores in one case),8 scores in 7 cases and 9 scores in 5 cases.In the study,clinical stage was for T2N0M0 in 16 cases,T3N0M0 in 1 case,T4NxM0 in 1 case and T3-4N1M1 in 3 cases.The treatments were hormonal therapy was chosen in 5 cases and radical prostatectomy was performed in 16 cases,including 16 cases with T2N0M0 stage and one case with T3N0M0.Results In those patients who accepted the radical prostatectomy,the duration of follow-up ranged from 3 to 65 months (mean 23 months).During the follow-up,14 patients had a lower incidence of biochemical recurrence.1 patient (T2,PSA 82.8 μg/L,GS 9) had external beam radiotherapy one month after the radical prostatectomy because of tumor invasion into the prostatic capsule.Then his PSA level returned to the 0.2 μg/L.1 patient (T3,PSA 38.9 μg/L,GS 8) had external beam radiotherapy 18 months after the radical prostatectomy because of biochemical recurrence and the tPSA level returned to the 4.0 μg/L.All patients who underwent radical prostatectomy had favourable recovery of urinary continence.In 5 patients who had androgen deprivation therapy,2 patients died after 63 or 65 months and one patient was lost to follow-up.The PSA level in one patient decreased from 71.8 μg/L to 2 μg/L after four months treatment.One patient had castration resistant prostate cancer and the adjuvant external beam radiotherapy was considered,subsequently.Conclusions Men under the 50 years old,who are diagnosed with localised prostate cancer,usually demonstrated the early clinic stage and high Gleason scores.It should not be discouraged from RP.Young men with metastatic prostate cancer have a poor prognosis.

Objective To investigate the expression and im plication of cell-cycle related factors(Cyclin D1,CDK4,P16 MTS1 and PRb)in condyloma acuminatum(CA).Methods The expression and distribution of cyclin D1,CDK4,P16 MTS1 and PRb were detected by immunohisto chemical technique streptavidin peroxidase(SP)in 27cases of HPV6/11positive CA that were confirmed by PCR and 10cases of norm al skins(foreskins).Results①Cyclin D1was not expressed in both normal skin and lesions of CA.②The intensity of expression of CDK4was 2.19in the basal cells in the lesions of CA,which was significantly weaker than that in normal skin(4.8,P

Objective To investigate compliance of breast cancer patients with postoperative peripherally inserted central catheter (PICC) in terms of upper limb motion, to formulate practical plan of upper limb motion, and to improve the compliance in the patients with PICC catheter.Methods A total of 75 patients after breast cancer operation with PICC for chemotherapy were selected from Department of Thyroid and Breast Surgery for upper limb activity instructions.Plan-Do-Check-Act method was used to evaluate the feasibility and effectiveness.Two cycles were performed in two weeks.Patients' compliance was assessed by the inquiry method.Results After practicing and refining nursing process, perfecting the risk assessment table, adjusting the education time, etc., the cognition and acceptance of the significance of upper limb motion were improved in the patients.The compliance of the patients to the upper limb motion instructions was satisfactory.Conclusions The upper limb motion scheme in this study was modified and perfected through application, research, and practice.This scheme could enhance the compliance of patients in terms of upper limb motion.

Objective:To investigate the current situation of students' academic procrastination behavior in medical colleges and universities and its influencing factors, and to put forward suggestions to reduce the academic procrastination of medical students.Methods:A total of 1 327 undergraduate students from three medical colleges and universities in Heilongjiang Province were randomly selected to receive questionnaire investigation on life satisfaction, anxiety, and academic procrastination. SPSS 23.0 was used for data analysis.Results:①The total procrastination scores of medical students were (35.00±8.92) points. ②There were statistical differences in the academic procrastination of medical students with different genders, whether the only children, the reasons for choosing the major, and the level of achievement ( P < 0.05). There was no statistical difference in academic procrastination among medical students of different ages and grades ( P > 0.05). ③Medical students' procrastination was positively correlated with their anxiety level ( r = 0.102, P < 0.01), and negatively correlated with life satisfaction ( r = -0.117, P < 0.01). ④Regression analysis showed that the following six predictive variables including the level of achievement, gender, life satisfaction, anxiety, reasons for choosing the major, and whether the only children could effectively explain the variance of 14.2% academic procrastination of medical students. Conclusion:The overall degree of academic procrastination of medical students is higher than that of non-medical students. And the students' achievement level, gender, life satisfaction, anxiety, the reasons for choosing this major and whether the only child are the influencing factors of academic procrastination.